The book opens with the well-known quote from Epictetus, a much
earlier philosophical source than that quoted above: 'People are
disturbed not by things but by the view they take of them'.

As agreeable as this latter proposal may be (especially for those
of the existential persuasion), it is the only reference to
philosophical tenets in the book: in spite of this paucity of allusions,
the authors and the founding practitioner Albert Ellis both insist that
clients need to take on a 'philosophical' outlook about their
distress. It is unclear as to which philosophical school they are
referring (one might infer the Stoics).

It is proposed that this statement demonstrates the '...
cornerstone' of the REBT (CBT) model: one's current situation
is not a product of intrapsychic conflict over unacceptable historical
antecedents, but ('largely') a result of one's attitude
towards any given experience (one can only speculate as to what
reservations are being held here).

Laudable as this statement might seem, a single epithet from a
philosopher's oeuvre does not suffice as a description of the human
condition.

This text fulfils its stated aim: '... to cover all of the key
elements of REBT theory and practice in as few words as possible'
(p.1). This is the very reason this reader would recommend it to anyone
looking to review or clarify the model in question. The authors use one
case example throughout the book to demonstrate the method, which
assists in the clear and concise discussion. The language is simple and
devoid of psychotherapeutic jargon.

At regular junctures, and in the final bibliography, references are
recommended for those who would wish to read further on the subject of
the paradigm.

By virtue of these qualities, I think the book would appeal to
practitioners and lay people alike: anyone who has an interest in
familiarising themselves with the basics of the various CBT approaches
now in use.

The 'Counselling in a Nutshell series seeks to ... provide
concise introductions to the key elements of theory and practice
underpinning major therapeutic approaches. The current portfolio
includes psychodynamic counselling and person-centred counselling.

As to the content of the book: Albert Einstein once reportedly
commented: 'everything should be made as simple as possible, but no
simpler'. The simplicity of the format of this book is not a
problem: the simplistic view of (all) the CBT models IS very much a
problem.

The CBT approach is woefully reistic: human beings are represented
as somewhat mechanistic entities. If their 'faulty thinking'
can be corrected, they can enjoy the benefits of a 'rational'
perspective that can modify (with a lot of 'trying' and
'hard work') their emotional experience as well as their
behaviour (and possibly their 'philosophy'). In this
perspective, there is no acknowledgement of the wonderful ambivalences
or contradictions that qualify human existence as perceived by other
philosophies and psychotherapy models.

Furthermore, some concerns may be raised as to the proposed
definitions of what qualifies as 'irrational': there are many
religious beliefs, as well as cultural norms, that might fall into this
category as it is outlined here. From an existential perspective, there
are many aspects with which one might take issue in the CBT paradigm.

It is fundamentally Cartesian: the 'mind',
'inside' the person, is invested with the power (and
justification) for ruling the emotions and behaviour of the individual.
With respect to this very fallacy, Cohn comments: 'In Western
thinking, reason and feelings have been considered predominantly as
separate functions ... Heidegger views this as another dualism to be
challenged: reason and feelings are both aspects of existence and cannot
be separate'" (Cohn, p.61, 2002).

There are further distinctions between existential thinking and the
theory of emotions as stated by REBT. According to the Dryden and Neenan
text, 'Rational thinking leads to a reduction in the intensity,
frequency, and duration of emotional disturbance' (p.7). The
'disturbing' emotions are then categorised as unhealthy or
inappropriate.

There is no sign of the appreciation that emotions, as well as
perception, cognition, feelings and intuition are disclosive: they
reveal to us how we find ourselves in the world. Heidegger discusses
this 'attunement', as it is translated, in Being and Time
(Heidegger, 1962). This disclosiveness, this attunement, is valuable
information in recognising how we are being, how we rare conducting
ourselves, how we are with others and how others are with us.

It might be suggested therefore, as does Rollo May (May, 1969),
that there are no emotions that are inappropriate, or unhealthy. All
emotions are indicative of an aspect of one's world-view, and
should be regarded as an inroad to the meaning and value constructions
held by the existent. This surely must be the appropriate exploration,
well before one even begins to consider changing the emotional
response(s).

Innumerable case studies (and personal experience) reveal that
people are often ambiguous with reference to what they purport to be a
desirable change in their behaviour, thought, emotions and/or
experience: 'I want to and I don't' is the frequent
report. The enquiry here would probably be with respect to what IS being
chosen, and experienced, and what is the possible loss in terms of
values (including the value placed on self-concept) that might be
incurred if things were to change. This query demands some investigation
before the benefits of the intended change are exalted as the
'rational' and solely appropriate basis for the modification.
In the REBT model, equivocation on the part of the client, for example,
the neglect of homework assignments or a 'relapse' into
previous behaviour is seen as a lack of commitment to the work on the
client's part. Nowhere in this text is there a consideration of the
how the efficacy of the practitioner might be evaluated, and how the
incompetence of the therapist might be an impediment to the client in
their pursuit of the desired modifications.

Furthermore, in the event of a lack of progress as defined by the
model, the client is exhorted to work harder in their efforts at
self-indoctrination: there is no query as to why the client might be
drawn to former modes of behaviour, especially in light of the notion
that their new 'rational' perspectives are providing them with
a more satisfactory experience. The existential perspective proposes
that all behaviour is purposeful (see the various vignettes in Sartre,
1991): this concept has no currency in the REBT model. If this proposal
was recognised, one would be inclined if not obliged to investigate this
aspect of the world-view (as one would explore emotional engagement in
the manner described previously).

There is one other essential omission in the REBT paradigm that
must not escape scrutiny: the co-constructive relationship of Self and
Other.

It is understandable that CBT/REBT was popularised by American
practitioners: it is very much in keeping with American cultural
traditions of individualism (see May et al, 1969). The individual in
this milieu is expected to be self-defining and self-sufficient. This
perspective is very much in antipathy with the concept of human
existence as inter-subjective and contextual.

Dryden and Neenan write in the chapter on 'Regular
Psychological Workouts' (post-therapy): ..[a].. client who believes
he no longer needs the approval of others and wishes to prove this to
himself might seek out situations where he might be criticized ... to
keep at bay his approval-seeking tendencies ... ("I don't want
or need to be ... told I'm a nice person in order to justify my
existence or please others to my own detriment") (p.77).

Such unilateral self-definition is unsupportable in existential
thought. Furthermore, the idea of self-sacrifice in order to serve the
wants or needs of others is one that is applauded in secular and
religious circles alike. In stark contrast to the idea espoused in
Dryden and Neenan, Sartre states "... he who sees me causes me to
be; I am as he sees me ..." (Sartre, quoted in Friedman, 1991,
p.189).

There are innumerable such expositions in the works of existential
writers, stating quite clearly the implications for
'being-with' that are fundamental to the process of knowing
oneself. It is a concept that cannot rest well with that of a REBT
model.

This concept of inter-subjectivity does not, however, suggest that
one can be totalised, finally or ultimately known; not by others, not
even by one self.

This notion of contextualised existence would extend as well to our
assumptions, perceptions, emotions and cognitions: all aspects of human
being are thus implicated. As Cohn writes: 'The individual living
in a 'with-world' can never be understood in isolation--s/he
has to be seen in the context of her/his 'with-being'. As the
context is in constant flux, the image of a fixed' internal'
psychic structure is a construction' (Cohn, 2002, p. 40).

Finally, the aims of existential psychotherapy and REBT are
incompatible: the latter focuses on the alleviation of distress via a
form of re-education, and the former model aims for a greater
understanding and appreciation of the human predicament, which may
result in an understanding of personal suffering, if not a mitigation of
the same. The process of existential psychotherapy, by virtue of its
premises, requires a dialogical engagement; the treatment program of
REBT requires primarily an instructor. This last proposal raises the
question: what is it that qualifies a process as psychotherapy, as
opposed to 'psychological treatment'?